Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients

Hamper, UM; Fishman, E K; Hartman, David S.; Roberts, JL; Sanders, R C

doi:10.2214/ajr.148.5.915

Cited by 51 publications

(24 citation statements)

References 11 publications

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“…Hamper et al in reviewed 26 patients with Adrenocortical carcinoma. 21 cases showed heterogenous echotexture with focal or scattered echopenic or echogenic zones representing areas of tumour necrosis, haemorrhage and/or calcification [7]. Mixed echogenic lesions on ultrasound: In our study out of 23 mixed echotexture lesions 2 were neuroblastoma, 2 pheochromocytomas, 5 carcinomas and 5 were metastases.…”

Section: Ultrasound Evaluation Of Adrenal Massesmentioning

confidence: 55%

Imaging features of various adrenal lesions

Archana¹,

Kumari²,

Chandra³

2016

APJHS

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Aim: To study the role of different imaging modalities in the detection and characterization of Adrenal lesions. Materials and Methods: In the present study for a period of 1 year comprised of 45 patients. All patients with Adrenal masses were evaluated with ultrasonography, NECT, CECT and few were further evaluated by MRI. Confirmation of diagnosis was by histopathology, clinical course or by pre and post operative confirmation of imaging findings wherever possible. Results: Of 45 cases 22 were benign, 16 were malignant and 07 were infectious. The distribution of Benign and malignant lesions were 48.8 : 35.5. In our study most of the Adrenal lesions are mixed echogenic constituting 15 (33.3%), which include both benign and malignant lesions. Most of the mixed echogenic lesions are malignant. Necrosis was commonly noted in most of the lesions constituting 12 (26.6%) of cases which is seen in Benign and Malignant and also in small & large lesions. Plain CT was done in 40 cases out of which 18 (40%) shoed mixed attenuation. Among them most were Malignant lesions. Calcifications are easily detected and are in Infectious and Malignant lesions constituting 10 (44%) of cases. CECT was done in 39 cases out of which most of them showed Non-Homogenous enhancement 19 (42.2%). In our study MRI was done only in 7 cases out of it 3 were Adenoma, which show more than 40% signal drop in T1 out of phase images which is diagnostic of Adenoma and differentiate it from Adenoma. Most of the lesions in our study were Metastasis mostly from Carcinoma Lung. Second common lesion in our study was Adrenal Adenoma. Ultra sound was done in all cases among which it could detect 34 (75 %) Lesions were detected. Plain CT was done in 40 cases among which 34 (185%) and CECT was done in 39 cases and diagnostic accuracy of CECT was 100%. Conclusion: This study detected the role of imaging modulaties in the detection and characterisation of adrenal lesions. It analysed imaging features of various adrenal lesions.

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Section: Ultrasound Evaluation Of Adrenal Massesmentioning

confidence: 55%

Imaging features of various adrenal lesions

Archana¹,

Kumari²,

Chandra³

2016

APJHS

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“…The presence of metastasis or vascular invasion indicates malignancy [3,10] . These tumors are reported to be associated with hemihypertrophy, Beckwith-Wiedemann syndrome, familial adenomatous polyposis and Li-Fraumeni syndrome [13] . Recently overexpression of IGF-II and H19 genes in Beckwith-Wiedemann syndrome, mutations in the APC gene and p53 tumor suppressor gene in familial adenomatous polyposis and Li-Fraumeni syndrome, respectively, have been proposed for genesis of adrenocortical carcinomas [11] .…”

Section: Discussionmentioning

confidence: 99%

“…Radiography has a limited role, however it can reveal an abdominal mass or calcification [12] . On sonography the appearance of adrenocortical neoplasms is variable; small lesions are usually round to oval, homogeneous, solid masses isoechoic to the renal cortex but can be uniformly hypoechoic or hyperechoic; large tumors are heterogeneous with central necrotic areas and can mimic multicystic kidneys [6,8,13,14] . A complex, predominantly hyperechoic pattern with radiating linear echoes, described as the scar sign has also been reported in carcinoma [13] .…”

Section: Discussionmentioning

confidence: 99%

“…On sonography the appearance of adrenocortical neoplasms is variable; small lesions are usually round to oval, homogeneous, solid masses isoechoic to the renal cortex but can be uniformly hypoechoic or hyperechoic; large tumors are heterogeneous with central necrotic areas and can mimic multicystic kidneys [6,8,13,14] . A complex, predominantly hyperechoic pattern with radiating linear echoes, described as the scar sign has also been reported in carcinoma [13] . In addition, tumor thrombus in the inferior vena cava, right atrium, renal and adrenal veins if present, can be detected on color Doppler imaging [15] .…”

Section: Discussionmentioning

confidence: 99%

“…On CT scans, adrenocortical tumors are typically circumscribed, appear variably heterogeneous due to hemorrhage and necrosis, and may display a thin capsule-like rim. Intratumoral calcification, which can be seen in about 20% of cases, can be reliably detected [13,14,16] . More specifically, CT demonstrates the exact extent of the lesion, its relation with adjacent organs, status of the inferior vena cava and presence of metastasis.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

An unusual presentation of congenital adrenocortical carcinoma: a case report and review of the literature

Singhal¹,

Kang²,

Khadwal³

et al. 2012

Cancer Imaging

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Oncologic imaging. Staging and follow-up of renal and adrenal carcinoma

McClennan

1991

Cancer

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Computed tomography (CT) has emerged from the 1980s to play a dominant role in the pretreatment staging of renal and adrenal carcinomas. For detection, definition (staging), and determination of resectability or recurrence, CT with intravenous contrast enhancement, and more recently, magnetic resonance imaging (MRI) with gadolinium-DTPA, may be the only cross-sectional imaging studies required before institution of appropriate therapy. Carcinoma of the kidney is frequently diagnosed by serendipity or detected on incidental ultrasound or CT examinations. Real-time ultrasound and color flow Doppler offer unique information on tumor vascularity and major venous vascular involvement. Positive predictive values of 96% can be achieved for the diagnosis of renal cell carcinoma using contrast-enhanced CT scanning. For follow-up CT and MRI are the best imaging techniques for evaluation of the retroperitoneum. MRI may distinguish tumor recurrence from fibrosis in selected cases. Because primary neoplasms of the adrenal gland are rare and often exceed 10 cm at the time of initial diagnosis, the functional nature (endocrine) of adrenal carcinoma may be part of the clinical presentation. Because initial stage is critical to survival and extent of surgical therapy, a knowledge of tumor classification is essential to the optimal diagnostic evaluation. Newer imaging tests, CT and MRI, have superseded conventional urography, ultrasound, and radionuclide studies for the diagnosis and staging of adrenal cancer. Early diagnosis and low stage at presentation are critical to survival in patients with adrenal carcinoma. The current concepts for pretreatment imaging evaluation and the role of CT, MRI, and ultrasound are outlined. An oncologic imaging approach based on tumor staging and classification for patients with real or suspected renal cell carcinoma and adrenal carcinoma is essential to optimal patient care.

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Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients

Cited by 51 publications

References 11 publications

Imaging features of various adrenal lesions

Imaging features of various adrenal lesions

An unusual presentation of congenital adrenocortical carcinoma: a case report and review of the literature

Oncologic imaging. Staging and follow-up of renal and adrenal carcinoma

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